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General NPI Number Information
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NPI Number | 1073563607
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Entity Type | Organization
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Legal Business Name | XME INC
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 06/29/2016
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Provider Practice Location Address
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Address Line | 314 W WACKERLY ST STE L
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City | MIDLAND
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State | MI
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Zip | 48640-2766
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Country | US
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Telephone | 989-839-2402
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Fax | 989-839-2405
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Provider Business Mailing Address
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Address Line | 314 W WACKERLY ST STE L
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City | MIDLAND
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State | MI
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Zip | 48640-2766
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Country | US
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Telephone | 989-839-2402
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Fax | 989-839-2405
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Authorized Official
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Title or Position | RPH
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Name | JENNIFER WYSOPAL
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Credential | RPH
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Telephone | 989-839-2403
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5301007501
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License Number State | MI
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